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Sarah Storey will not return to Rio, where she won three golds in 2016, after advice on yellow fever vaccination following an outbreak of the disease in Brazil. Photograph: Andrew Matthews/PA

The 14-time Paralympic champion Dame Sarah Storey has withdrawn from the Great Britain team for the Para-cycling Track World Championships in Rio later this month.

The 40-year-old announced her decision on Thursday, following advice regarding yellow fever vaccination after an outbreak of the disease in Brazil.

Storey gave birth to her son Charlie last year and the four-and-a-half-month-old is breastfed, which means neither mother nor baby can be vaccinated, she said.

“I am obviously disappointed to not be able to compete at the event and miss out on the opportunity to win another rainbow jersey but the health and wellbeing of my family is far more important,” Storey said.

“I am not prepared to risk travelling unvaccinated as contracting the infection results in a high percentage of fatalities.”

Friday, March 9, 2018

Brazilian researchers have determined that Yellow Fever may have been underestimated, with a patient who survived the disease still showing signs of it nearly a month after infection.

Previously, scientists operated on the idea that yellow fever had a transmissibility period that roughly correlated to acute infections–a period of no more than 10 days. Most symptoms vanished after three or four days, though a small percentage of patients would enter a second phase of the disease that boasts a 50 percent death rate within 7 to 10 days. With the virus now showing up in urine and semen a month after infection, this significantly increases the danger of infection according to Paolo Zanotto, a professor at the University of São Paulo’s Biomedical Science Institute (ICB-USP).

“We don’t yet have enough samples to determine how long yellow fever virus can be detected in urine and semen, but our monitoring of the patient for 21 days after observing the first symptoms of the disease suggests the virus can be detected in these biological materials for almost a month after infection, if not longer,” Zanotto said.

Sequencing the genome of the virus isolated in their patient’s urine, researchers say this indicates yellow fever is an arbovirus–a type of virus transmitted by insects that feed on blood–and capable of being excreted through the urinary system. They do not know how long it stays with that system yet, or what the implications of it might be.

Researchers also said tests designed to detect yellow fever in urine can improve diagnosis. This is especially important given that more than half of those infected do not display any symptoms, and thus are not admitted to a hospital.

“The people who are admitted to hospital are those who have symptoms,” Zanotto said. “These are the relatively severe cases, representing the tip of the iceberg as far as the problem of infection by yellow fever in Brazil is concerned since a large proportion of those infected is asymptomatic.”

The ICB-USP conducted this study alongside colleagues from Butantan Institute, Emílio Ribas Infectology Institute, and Pontifical Catholic University of São Paulo (PUC-SP), and published their findings in the CDC journal Emerging Infectious Diseases.

Large swaths of Brazil have long been at risk for yellow fever. But the previous outbreak and the current one are happening in areas not previously considered at risk for the disease and where vaccination rates were low. The current outbreak is hitting the populous states of Sao Paulo and Minas Gerais hard and encroaching on major cities.

Saturday, March 3, 2018

The Centers for Disease Control and Prevention (CDC) has released a list of clinics stocking the yellow fever vaccine, Stamaril (Sanofi Pasteur). They have also created an interactive map allowing travelers and clinicians to easily search locations with the vaccine that are nearest to them. The map will be updated periodically to include any updates to clinic locations.

The distribution of Stamaril is due to the total depletion of YF-Vax, the only licensed yellow fever vaccine in the U.S. Sanofi Pasteur has stated they expect YF-Vax to be available again by the end of 2018.

Stamaril, which is manufactured in France, received approval through the Food and Drug Administration's investigational new drug (IND) program (despite the name, the vaccine is not investigational or experimental and has been used in Europe for years). It is comparable to YF-Vax in safety and efficacy.

As part of the IND program, only a limited number of clinics will be provided Stamaril.

About Me

I am a pediatrician based at Mohali, a suburb of chandigarh, North India. I have my own virtual office at www.charakclinics.com; I have been a pediatrician since 1994. I hope to make ths blog a regular feature with tonnes of relevant info for parents, especially in India, because i feel that "informed parents are better parents". My interests include research in OPD practice, specifically new vaccines and travel medicine. I am a member of American Academy of Pediatrics, Indian Academy of Pediatrics, and various travel organizations like International Society for Travel Medicine (ISTM), American Society of Tropical Medicine & Hygiene (ASTMH), International Association for Medical Assistance to Travelers (IAMAT), and British & Global Travel Health Association (BGTHA)